Chen Ming, Zeng Shu Ying, Lu Sheng Jia, Shi Miao, Zhang Qing Qian
Department of Respiratory and Critical Care Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, China.
Clinical Medical College of Integrated Chinese and Western Medicine, Zhejiang Chinese Medicine University, Hangzhou, China.
Front Med (Lausanne). 2025 Jun 11;12:1574706. doi: 10.3389/fmed.2025.1574706. eCollection 2025.
Chlamydia parrot pneumonia (CPS) is a rare community-acquired pneumonia (CAP) caused by Chlamydia parrot infection. With the development of metagenomic second-generation sequencing technology (mNGS), its diagnostic rate has improved in recent years. However, there are few clinical studies on Chlamydia parrot pneumonia, especially for patients with low and intermediate pneumonia severity index (PSI), and the necessity of early review of chest computed tomography (CT) is not clear. This study aimed to explore the clinical significance of early review of chest CT in patients with low and intermediate risk of Chlamydia parrot pneumonia with PSI after initial treatment was effective.
Retrospective analysis of 8 patients with pneumonia diagnosed by metagenomic next-generation sequencing (mNGS) admitted to Zhejiang Provincial Tongde Hospital from January 2020 to December 2022 (PSI score ≤ 130 points). All patients had improved clinical symptoms and inflammatory markers after receiving antibiotic treatment, and chest CT was reexamined within 5-12 days. Evaluate the correlation between imaging changes before and after treatment and clinical symptoms and inflammatory indicators (CRP, PCT, WBC, etc.).
After treatment, the patient's body temperature, CRP, PCT and other indicators decreased significantly ( < 0.05). However, early CT reexamination showed that imaging progressed in 5 cases (62.5%), was stable in 2 cases (25%), and only 1 case (12.5%) showed partial improvement ( > 0.05). Nevertheless, none of the patients had a deterioration in their condition later on and finally achieved imaging recovery. Clinicians did not adjust the treatment plan when imaging progressed, and only 1 case was given glucocorticoid additionally.
For patients with low- intermediate risk pneumonia with low PSI, if clinical symptoms and inflammatory markers improve, early reexamination of chest CT may have no additional clinical value and does not affect treatment decisions. Therefore, it is not recommended to routinely perform early CT re-examination for such patients to reduce unnecessary consumption of medical resources. Larger sample studies are needed in the future for further verification.
https://www.medicalresearch.org.cn/login, identifier MR-33-25003507.
鹦鹉热衣原体肺炎（CPS）是一种由鹦鹉热衣原体感染引起的罕见社区获得性肺炎（CAP）。随着宏基因组二代测序技术（mNGS）的发展，近年来其诊断率有所提高。然而，关于鹦鹉热衣原体肺炎的临床研究较少，尤其是对于肺炎严重程度指数（PSI）为低、中度的患者，早期复查胸部计算机断层扫描（CT）的必要性尚不清楚。本研究旨在探讨在初始治疗有效后，对PSI为低、中度风险的鹦鹉热衣原体肺炎患者早期复查胸部CT的临床意义。
回顾性分析2020年1月至2022年12月在浙江省同德医院住院的8例经宏基因组下一代测序（mNGS）确诊的肺炎患者（PSI评分≤130分）。所有患者在接受抗生素治疗后临床症状和炎症指标均有所改善，并在5-12天内复查胸部CT。评估治疗前后影像学变化与临床症状及炎症指标（CRP、PCT、WBC等）之间的相关性。
治疗后，患者体温、CRP、PCT等指标显著下降（<0.05）。然而，早期CT复查显示，5例（62.5%）影像学进展，2例（25%）稳定，仅1例（12.5%）有部分改善（>0.05）。尽管如此，所有患者病情均未进一步恶化，最终实现影像学恢复。影像学进展时临床医生未调整治疗方案，仅1例额外给予糖皮质激素。
对于PSI为低、中度风险的肺炎患者，若临床症状和炎症指标改善，早期复查胸部CT可能无额外临床价值，且不影响治疗决策。因此，不建议对此类患者常规进行早期CT复查，以减少不必要的医疗资源消耗。未来需要更大样本量的研究进一步验证。
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